Discuss cultural and ethical considerations in diagnosis.

Bias.Different cultural groups have different attitudes towards disorders.Culture-bound syndromes could be difficult to recognize for clinicians and could lead to misdiagnosis

Zhang (1998)

neurasthenia is Chinese variation of depression

Ethical considerations

Correct diagnosis and treatmentBias in diagnosis (gender, ethnicity, age).Clinicians may also be influenced by confirmation bias (ignoring information that contradicts their original diagnosis)

Rosser (1992)

women more likely than men to be diagnosed

Women are diagnosed more than males because they

Behave in ways that people label as mental disorders.Taught to express their emotions, while men are trained to control them.Have unequal social positions and greater discrimination, more likely to experience trauma-inducing circumstances

Etiologies (causes) of one eating disorder

A sample of female twins participated in the study. One twin of each pair had bulimia.

Type of study

Longitudinal (over time) study and researchers conducted interviews to see if the other twin would develop bulimia and if concordance rates were higher in identical or fraternal twins.

Results

Concordance rate higher for identical twins.

Evaluation

Results show a heritability of 55% but this leaves 45% for other factors.Genetic vulnerability might develop bulimia, but other factors trigger the disorder.Environmental factors not taken into account (dysfunctional environment could have been a trigger.)Findings cannot be generalized (gender bias).

Participants went to twelve hospitals in the US and stated that they were hearing voices.

Results

All pseudo-patients admitted and all but one diagnosed with schizophrenia.All pseudo-patients behaved normally while hospitalized because they could only get out if the staff perceived them to be well.Pseudo-patients took notes (this was actually interpreted by the staff as a symptom of their illness)

Length

It took 7 to 52 days before patients released and labelled “schizophrenia in remission”

Follow-up

Staff at a hospital told they were being sent pseudo-patients.41 identified as imposters by at least one staff member, but no imposters actually sent.Reveals issues with validity and reliability of diagnosis.

Evaluation

Revision of diagnostic procedures. The development of diagnostic manuals have increased reliability and validity of diagnosis.

Ethical issues

Staff members were deceived in both studies.In the second study, actual patients may not have received proper treatment because the staff was looking for imposters.